Gallstones are usually attributable to an over-concentration of stone-forming substances such as, for example, cholesterol, lime and the like, or else an infection of the gall bladder, and operations for the removal of gallstones are relatively common. Removal of stones accumulated in the gall bladder is, in any case, necessary when they lead to severe colic, which produce cramp-like abdominal pains, outbreaks of sweating, and nausea. At present the removal of gallstones is only possible by open surgery, with all its risks and disadvantages.
DE-OS No. 29 23 105 describes an instrument for gall bladder operations which basically makes endoscopic intervention possible. With this instrument, after the removal of a trocar and a trocar sleeve, a short trocar sleeve insert with relatively wide free operating space is inserted into the abdominal wall and is fixed on the operating table by means of a tripod linkage. Then the operation endoscope or the like is introduced into the body cavity through the trocar sleeve insert.
Although a trocar sleeve insert which is thus fixed may facilitate the endoscopic treatment of organs such as, for example, the gall bladder, it does not ensure that the operation endoscope and the trocar are adequately fixed with respect to the organ to be operated on. A movement or positional change of the patient causes movement of the insert because it is fixed to the operating table. Also there is a risk that the position of the organ to be treated, for example, the gall bladder, may change before or during the operation.
A main object of the present invention is to provide an instrument for endoscopic operations which can be fixed securely in position with respect to the organ to be treated.